Individual provider Active NPI

Kathy L Promenchenkel

  • Case Manager/Care Coordinator
  • Yucca Valley, CA
National Provider Identifier
1700062528
Registry record updated Dec 29, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Case Manager/Care CoordinatorTaxonomy code 171M00000X
Practice address
58945 Business Center Dr Ste J
Yucca Valley, CA 92284-7310
Phone
(760) 369-1074
Fax
(760) 418-8271
NPI assigned
Jan 10, 2008
Last updated
Dec 29, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 29, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 1406 CA
Case Manager/Care Coordinator 171M00000X CA Primary

Addresses

Primary practice location

58945 Business Center Dr Ste J
Yucca Valley, CA 92284-7310

Mailing address

7885 Annandale Ave
Desert Hot Springs, CA 92240-1419
Phone (760) 329-2924

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
The Ranch Recovery Centers Inc Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1199923200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1766966400000",
    "number": "1700062528",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7885 ANNANDALE AVE",
            "city": "DESERT HOT SPRINGS",
            "state": "CA",
            "postal_code": "922401419",
            "telephone_number": "760-329-2924"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "58945 BUSINESS CENTER DR STE J",
            "city": "YUCCA VALLEY",
            "state": "CA",
            "postal_code": "922847310",
            "telephone_number": "760-369-1074",
            "fax_number": "760-418-8271"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PROMENCHENKEL",
        "first_name": "KATHY",
        "middle_name": "L",
        "name_prefix": "Ms.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-01-10",
        "last_updated": "2025-12-29",
        "certification_date": "2025-12-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "CA",
            "license": "1406",
            "primary": false
        },
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": "CA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Yucca Valley, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 29, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.